News 03.30.20 : Today’s Articles of Interest from Around the Internets

For thousands of years, a parasite with no name lived happily among horseshoe bats in southern China. The bats had evolved to the point that they did not notice; they went about their nightly flights unbothered. One day, the parasite—an ancestor of the coronavirus, sars-CoV-2—had an opportunity to expand its realm. Perhaps it was a pangolin, the scaly anteater, an endangered species that is a victim of incessant wildlife trafficking and sold, often secretly, in live-animal markets throughout Southeast Asia and China. Or not. The genetic pathway remains unclear. But to survive in a new species, whatever it was, the virus had to mutate dramatically. It might even have taken a segment of a different coronavirus strain that already inhabited its new host, and morphed into a hybrid—a better, stronger version of itself, a pathogenic Everyman capable of thriving in diverse species. More recently, the coronavirus found a new species: ours. Perhaps a weary traveller rubbed his eyes, or scratched his nose, or was anxiously, unconsciously, biting his fingernails. One tiny, invisible blob of virus. One human face. And here we are, battling a global pandemic.

If the dozens of places where a coronavirus vaccine might be born, one is DIOSynVax, a small company started by a Canadian pathologist named Jonathan Heeney. In ordinary times, I’d have visited Heeney in his office, in a stately red-brick building in Cambridge. I’d have met his team and his Aria III cytometer, which looks like as if might brew a strong, space-age espresso but which, in fact, uses its four lasers to separate cells marked with fluorescent dyes as they flow through the machine at 10,000 cells per second. I’d have tried to wangle my way into the lab designated containment level 3, the highest-but-one level of biosafety security, where Heeney’s biologists investigate pathogens such as the West Nile virus or the tuberculosis bacterium. These would be so lethal if they escaped that the lab is nearly hermetic. The joints along the walls, floor and ceiling are sealed and re-sealed; the steel panels in the walls, according to government guidelines, have to be “of the type used in the nuclear industry”; a flow of air must constantly be forced in if the door is open, to prevent the germs inside from drifting out. I would have even seen the coronavirus vaccine candidates themselves: samples of clear liquid, held in glass vials.

But Heeney couldn’t take the risk. Understandably, he didn’t want anyone carrying Covid-19 into his lab and infecting his staff. “It’s a challenge already, because when they go home to their families every day, you don’t know who they’re passing on the bus or the train,” he said when I first spoke to him last week. At the time, Heeney was considering quarantining himself. A Cambridge college had offered him a room, so that he could shuttle between lab and bed, meeting as few people as possible. “I don’t have time to get sick,” Heeney said. He runs his company out of Cambridge University’s department of veterinary medicine, where he is a professor. He’s just a 12-minute bicycle ride from where I live, but we video-conferenced on Zoom.

Since 2016, Heeney has been honing a set of methods – a platform, in vaccine parlance – that can be used to fashion vaccines that destroy whole families of viruses. Last year, he won a Gates Foundation grant of $2m (£1.6m) to fund research into a universal flu vaccine – one that will prevail against every kind of flu virus. “It’s the mother of all challenges, the holy grail,” Heeney said. In January, he kept an eye on a new disease that was flying across eastern China. After two weeks, when Chinese scientists published the coronavirus’s genetic sequence, Heeney told me his team decided: “Let’s do with this what we’re doing with the flu.”

Defeating Covid-19 will call for more than vaccines; it will involve quarantines, social distancing, antivirals and other drugs, and healthcare for the sick. But the idea of a vaccine – the quintessential silver bullet – has come to bear an almost unreasonable allure. The coronavirus arrived at a ripe moment in genetic technology, when the advances of the past half-decade have made it possible for vaccine projects to explode off the blocks as soon as a virus is sequenced. These cutting-edge vaccines don’t use weakened forms of the germ to build our immunity, as all vaccines once did; rather, they contain short copies of parts of the germ’s genetic code – its DNA or RNA – which can produce fragments of the germ within our bodies.

Life has been no party lately. Coronavirus has shattered our routines, pitched our economy into free fall and left us stunned. We’ve been stripped of our social safety nets, those customary conversations with neighbors, friends and family. We’re isolated and split off from each other like fish from water.

Seclusion is punishing. It strips us of our identities, the ways we recognize ourselves. Many of us have lost jobs — or at least the collegiality jobs bring — and our usual run of errands to do. No more school drop-offs, baseball carpools and dinners out; no more trips, parties or March Madness over beers. Spring Break is broken, and our points of reference have evaporated.

Without those we float, homebound but restless. The only person we dare approach is that partner of ours who’s stuck at home, too. But sometimes he, she or they annoy the hell out of us.

The new coronavirus has brought American life to a near standstill, closing businesses, canceling large gatherings, and keeping people at home. All of those people must surely be wondering: When will things return to normal?

The answer is simple, if not exactly satisfying: when enough of the population—possibly 60 or 80 percent of people—is resistant to COVID-19 to stifle the disease’s spread from person to person. That is the end goal, although no one knows exactly how long it will take to get there.

There are two realistic paths to achieving this “population-level immunity.” One is the development of a vaccine. The other is for the disease to work its way through the population, surely killing many, but also leaving many others—those who contract the disease and then recover—immune. “They’re just Teflon at that point,” meaning they can’t get infected again and they won’t pass on the disease, explains Andrew Noymer, a public-health professor at the UC Irvine. Once enough people reach Teflon status—though we don’t yet know if recovering from the disease confers any immunity at all, let alone lifelong immunity—normalcy will be restored.

Unfortunately, both of these paths could be a year or two long, but degrees of normalcy will likely be won back in the meantime: Come summer, Americans might get restaurants but no music festivals, offices but no crowded beaches, bars with spaced-out seating. Projecting when each facet of daily life will be restored would be easier if public-health authorities had an omniscient view of who is infected, who has recovered and become immune, and who is still susceptible—this is the information that would emerge from widespread testing, which the United States is terribly behind on deploying.

As such, America is currently left with self-isolation, a blunt tactic that can slow the spread of the virus, potentially sparing the country’s hospitals from a catastrophic overload of patients, but that comes at the cost of freezing daily life. Epidemiologists I interviewed stressed that they have no idea when life will be unfrozen, but they walked me through a series of possible timelines on which Americans might be able to safely start leaving the house to make money or do fun things again. Below are those timelines, including some turning points to look out for in the coming weeks, months, and years.

No matter what, staying safe means staying home for a while yet, despite Donald Trump’s desire, expressed at a Fox News town hall on Tuesday, “to have the country opened up, and just raring to go, by Easter.” Moving back toward normalcy at this early stage could be disastrous. “Prematurely ending severe social distancing would be an incredible blunder that would have major human consequences,” Noymer told me. “What is ‘prematurely’? The truth is, we don’t know yet, exactly, but it’s longer than a fortnight. It could be eight to 12 weeks.”

When the definitive history of the coronavirus pandemic is written, the date 20 January 2020 is certain to feature prominently. It was on that day that a 35-year-old man in Washington state, recently returned from visiting family in Wuhan in China, became the first person in the US to be diagnosed with the virus.

On the very same day, 5,000 miles away in Asia, the first confirmed case of Covid-19 was reported in South Korea. The confluence was striking, but there the similarities ended.

In the two months since that fateful day, the responses to coronavirus displayed by the US and South Korea have been polar opposites.

One country acted swiftly and aggressively to detect and isolate the virus, and by doing so has largely contained the crisis. The other country dithered and procrastinated, became mired in chaos and confusion, was distracted by the individual whims of its leader, and is now confronted by a health emergency of daunting proportions.

Within a week of its first confirmed case, South Korea’s disease control agency had summoned 20 private companies to the medical equivalent of a war-planning summit and told them to develop a test for the virus at lightning speed. A week after that, the first diagnostic test was approved and went into battle, identifying infected individuals who could then be quarantined to halt the advance of the disease.

Some 357,896 tests later, the country has more or less won the coronavirus war. On Friday only 91 new cases were reported in a country of more than 50 million.

The US response tells a different story. Two days after the first diagnosis in Washington state, Donald Trump went on air on CNBC and bragged: “We have it totally under control. It’s one person coming from China. It’s going to be just fine.”

‘A fiasco of incredible proportions’
A week after that, the Wall Street Journal published an opinion article by two former top health policy officials within the Trump administration under the headline Act Now to Prevent an American Epidemic. Luciana Borio and Scott Gottlieb laid out a menu of what had to be done instantly to avert a massive health disaster.

Top of their to-do list: work with private industry to develop an “easy-to-use, rapid diagnostic test” – in other words, just what South Korea was doing.

It was not until 29 February, more than a month after the Journal article and almost six weeks after the first case of coronavirus was confirmed in the country that the Trump administration put that advice into practice. Laboratories and hospitals would finally be allowed to conduct their own Covid-19 tests to speed up the process.

Today, 86,012 cases have been confirmed in the US, pushing the nation to the top of the world’s coronavirus league table

Those missing four to six weeks are likely to go down in the definitive history as a cautionary tale of the potentially devastating consequences of failed political leadership. Today, 86,012 cases have been confirmed across the US, pushing the nation to the top of the world’s coronavirus league table – above even China.

More than a quarter of those cases are in New York City, now a global center of the coronavirus pandemic, with New Orleans also raising alarm. Nationally, 1,301 people have died.

Most worryingly, the curve of cases continues to rise precipitously, with no sign of the plateau that has spared South Korea.

“The US response will be studied for generations as a textbook example of a disastrous, failed effort,” Ron Klain, who spearheaded the fight against Ebola in 2014, told a Georgetown university panel recently. “What’s happened in Washington has been a fiasco of incredible proportions.”